女性冠状动脉血管反应性和功能能力受损：美国国立心肺血液研究所女性缺血综合征评估（WISE）研究的结果。

Impaired coronary vascular reactivity and functional capacity in women: results from the NHLBI Women's Ischemia Syndrome Evaluation (WISE) Study.

作者信息

Handberg Eileen, Johnson B Delia, Arant Christopher B, Wessel Timothy R, Kerensky Richard A, von Mering Gregory, Olson Marian B, Reis Steven E, Shaw Leslee, Bairey Merz C Noel, Sharaf Barry L, Sopko George, Pepine Carl J

机构信息

Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, Florida 32610-0277, USA.

出版信息

J Am Coll Cardiol. 2006 Feb 7;47(3 Suppl):S44-9. doi: 10.1016/j.jacc.2005.10.023.

DOI:10.1016/j.jacc.2005.10.023

PMID:16458171

Abstract

OBJECTIVES

We investigated the relationship between coronary vascular reactivity and functional capacity as assessed from the Duke Activity Status Index (DASI) in a cohort of women evaluated for suspected ischemia.

BACKGROUND

Reduced functional capacity and impaired vascular reactivity are associated with poor prognosis, but an association between vascular reactivity and functional capacity is unknown.

METHODS

A total of 190 women enrolled in the National Heart, Lung, and Blood Institute (NHLBI)-sponsored Women's Ischemia Syndrome Evaluation (WISE) study had baseline clinical assessment and coronary artery flow velocity response to adenosine (CFVR(ado)). We compared these results with self-reported DASI metabolic equivalents (METs).

RESULTS

Mean age was 55 +/- 11 years (range 21 to 83 years), and only 18% had coronary stenosis > or =50%. Women with a CFVR(ado) <2.5 (n = 98) had mean DASI of 15.1 +/- 13.6, compared to women (n = 92) with CFVR(ado) > or =2.5, whose mean DASI was 21.0 +/- 15.2 (p = 0.004). This relationship was maintained after adjusting for age and presence of coronary artery disease. CFVR(ado) of > or =2.5 was associated with a DASI of >20 (odds ratio 3.03, 95% confidence interval 1.56 to 5.90, p = 0.001).

CONCLUSIONS

Women with reduced CFVR(ado) were significantly more likely to have reduced functional capacity. Impairment in coronary vascular function and reduced levels of activity may both play a role in the poorer prognosis observed in the WISE study women; however, the relationship between the two is still unclear.

摘要

目的

在一组因疑似缺血而接受评估的女性队列中，我们研究了根据杜克活动状态指数（DASI）评估的冠状动脉血管反应性与功能能力之间的关系。

背景

功能能力降低和血管反应性受损与预后不良相关，但血管反应性与功能能力之间的关联尚不清楚。

方法

共有190名参加美国国立心肺血液研究所（NHLBI）资助的女性缺血综合征评估（WISE）研究的女性进行了基线临床评估以及对腺苷的冠状动脉血流速度反应（CFVR(ado)）。我们将这些结果与自我报告的DASI代谢当量（METs）进行了比较。

结果

平均年龄为55±11岁（范围21至83岁），只有18%的女性冠状动脉狭窄≥50%。CFVR(ado)<2.5的女性（n = 98）的平均DASI为15.1±13.6，而CFVR(ado)≥2.5的女性（n = 92）的平均DASI为21.0±15.2（p = 0.004）。在调整年龄和冠状动脉疾病的存在后，这种关系仍然存在。CFVR(ado)≥2.5与DASI>20相关（比值比3.03，95%置信区间1.56至5.90，p = 0.001）。